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WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTt
REGIONAL OFFICE FOR THE
EASTERN MEDITERRANEAN
BUREAU REGIONAL DE LA
MEDITERRAN~E ORIENTALE
EMjRC20A/Min.2 REGIONAL COMMITTEE FOR THE EASTERN MEDITERRANEAN 22 September 1970
Twentieth Session Original: ENGLISH
SUB-COMMITTEE A
MINUTES OF THE SECOND MEETING
Held at the Printania Palace Hotel, Broummana, Lebanon on Tuesday, 22 September 1970, at 8.30 a.m.
CHAIRMAN: Dr. J. Anouti (Lebanon) later: Mr. Y.J. Al-HijJi (Kuwait)
CONTENTS
1. Annual Report of the Regional Director to the Twentieth Session of the Regional Committee:
Statements and reports by Representatives of Member States (continued)
2. Co-operation with other Organizations and Agencies:
Statements and reports by Representatives and Observers of Organizations and Agencies
3. Long-term Planning in the Eastern Mediterranean Region:
(a) Fifth General Programme of Work for a Specific Period
(b) Long-term Financial Indicators
4. Resolutions of Regional interest adopted by the Twentythird World Health Assembly and by the Executive Board at its Forty-fifth and Forty-sixth Sessions
5
19
25
25
EM/RC20A;Min.2 page 2
Representatives of Member States
Governments
AFGHANISI'AN
CYPRUS
FRANCE
IRAN
IRAQ.
KUWAIT
IEBANON
LIBYA
PAKISTAN
SAUDI ARABIA
SOMALIA
SOUTHERN YEMEN
SUDAN
SYRIA
TUNISIA
UNITED ARAB REPUBLIC
YEMEN
Representative, Alternate or Adviser
Professor A. Omar Dr. R. Roashan
Dr. V. Vassilopoulos
Dr. G. Orthlieb
Dr. H. Morshed Mr. A.N. Amir-Ahmadi
Dr. I. Al-Nouri
Mr. Y.J.· Al-Hijji
Dr. J. Anouti Dr. H.H. Jalloul Dr. F. Maalouly Mr. J. Andari Dr. K. Arab Dr. T. Al-Awar
Dr. A.M. Abdel Hadi Dr. O. Kadiki
Brigadier C.K. Hasan Dr. S. Hasan
Dr. H.S. Dabbagh Dr. A.S. Tabba'a
Mr. O.H. Hassan Dr. K.M. Sufi
Dr. A.S. Affara Dr. A. Abdul Wali
Dr. A.A. El Gaddal
Dr. N. Rarnzi Dr. A. Budeir
Dr. M. Bahri
Dr. H. El Kadi Dr. A.G. Khallaf Dr. L. Aboul Nasr Dr. E.E. Galal
iofi.. A .M. El Saidi Dr. M.K. El Aghbari
Representatives of Associate Member States
EM/RC20A/Min.2 page 3
Government Representative, Alternate or Adviser
BAHRAIN
QATAR
World Health Organization
Secretary to the Sub-
Dr •. A. Fakhro
Dr. S.A. Tajeldeen Mr. M.G. Al-fein
Committee (ex-officio) Dr. A.H. Taba, Regional Director
Planning and Co-ordination Officer, EMRO Dr. S. Hasan
Representatives of United Nations Organizations
UNITED NATIONS CHILDREN'S Mr. R. Koleilat FUND (UNICEF) Deputy Regional Director, UNICEF, Beirut
UNITED NATIONS RELIEF AND WORKS AGENCY FOR Dr. M. Sharif PAlESTINE REFUGEES Director of Health and WHO Representative, (UNRWA) UNRWA, Beirut
Representatives and Observers of Inter-governmental, International Non-governmental and National Organizations
IEAGUE OF ARAB STATES
INTERNATIONAL DENTAL FEDERATION
INTERNATIONAL UNION FOR HEALTH EDUCATION
THE WORLD FEDERATION FOR MENTAL HEALTH
INTERNATIONAL COUNCIL FOR NURSES
INTERNATIONAL PLANNED PARENTHOOD FEDERATION
INTERNATIONAL COMMITTEE OF THE RED CROSS
Dr. G. Zerikly
Dr. E. Sawaya
Mrs. Aida C. Shamma
Dr. A. Manugian
Mrs. Aida Sultan
Dr. I. Nazer
Mrs. G. Shoucair
EM;RC20A,lMin.2 page 4
Representati V$ and Observers of Inter-:governmental> International Non-governmental and National Organizations (cont'd)
WORLD FEDERATION OF PUBLIC HEALTH ASSOCIATIONS Dr. M.H. Hafezi
UNITED STATES NAVAL MEDICAL RESEARCH UNIT No.3 (NAMRU 3) Dr. H.A. Sparks
INTERNATIONAL STATISTICAL EDUCATION AND RESEARCH CENTRE (ISEC) Mr. F. El Khouri
EM/RC20A/Min.2 page 5
1. ANNUAL REPORT OF THE REGIONAL DIREC'rOR TO THE 'IWENrIETH SESSION OF THE REGIONAL COMMITrEE: STATEMENrS AND REPORTS BY REPRESENTATIVES OF MEMBER STATES: Item 5 of the Agenda (Document EM/RC20/2) (continued)
Dr. AFFARA (Southern Yemen) said that in the two years since it had
attained independence ~s country had been grappling with many health problems
which it had inherited from the past and was determined to overcome. It
was concentrating in particular on the provision of health services for
areas which had long been deprived of them, with emphasis on prevention. A
five-year national social and economic development plan, including a number
of health projects, was at present being prepared. In the curative field,
emphasis was being laid not merely on the provision of hospital facilities,
but also on taking medical care to the people's homes, together with health
education, maternal and child health and environmental health activities.
This would be achieved through the establishment of health centres from
which mobile units would radiate into the rural areas.
In April 1970, the Regional Adviser on Public Health Administration had
visited the country and found the main public health laboratory to be un
satisfactory; he had made a number of recommendations for its improvement.
Following a visit by the Regional Adviser on Pharmacy and Medical
Supplies, steps had been taken to develop pharmaceutical services in Southern
Yemen, but progress had now been halted owing to the departure of the
pharmacist aSSigned by the Regional Office. It was hoped that a replacement
would soon be provided.
The country's health statistical services needed complete ,reorganization
so that reliable numerical data on its health problems could be available.
The visit by the Regional Office Adviser on the subject had been welcomed and
it was hoped that an expert could be appointed to assist the Government.
In the realm of preventive medicine, a BCG vaccination programme had
been started in January 1970, with the aim of achieving complete coverage of
the population within three years. A malaria eradication plan was also being
prepared with the help of WHO.
EMjRC20A/Mih.2 page 6
Pulmonary tuberculosis was one of the major health problems in Southern
Yemen, owing largely to nutritional deficiencies and bad environmental
conditions. There was no doubt of the protective value of BeG vaccination.
Nevertheless, it was a many-faceted problem and it was essential that a
comprehensive control programme be prepared with WHO and UNICEF participation.
In the absence of a WHO expert it was difficult for the Government to under
take a control programme on its own. The disease constituted a heavy economic
burden for a country which was struggling to overcome its difficulties in
that field, and he hoped that WHO would realize the urgency of the need.
He was grateful to the Regional Director for arranging a visit by the
Regional Tuberculosis Adviser to look into the aituation.
The outbreak of cholera in the Region was a serious threat not only to
human life but also to trade and other international relations. He was
grateful to WHO for its assistance in tackling the problem and also to the
United Arab Republic for providing vaccines and other supplies. He could
state categorically that no cases had occurred in Southern Yemen, but
preventive measures had been taken.
With regard to education and training of health personnel, the need
was particularly acute in his country since upon its attaining independence
large numbers of expatriate staff had been withdrawn, and the situation was
further aggravated by deterioation of the existing equipment. Staff were
defective in quality as well as quantity, since many of those remaining had
had only brief on-the-job training. He was therefore particularly grateful
to the Regional Director for the assistance he was providing to the project
for the establishment of an institute for health manpower development.
In conclusion, he strongly endorsed the remarks made by the Regional
Director on pages 11-12 of the Annual Report on the importance of WHO's
fellowship programme.
Dr. RAMZI (Syria) agreed with the Regional Director about the
importance of long-term planning. In his country, on the basis of the
experience acquired in the implementation of the first and second five-year
EMjRC20A/Min.2 page 7
plans, a third plan for the years 1971 - 1975 was now being prepared, with
emphasis on co-ordinated social and economic development adapted to the
country's resources. A tripartite agreement between WHO, UNICEF and his
Government for the development of the health services during that five-year
period was now being finalized. It laid great emphasis on training of
qualified personnel at all levels. His Government was grateful for all the
assistance it had received in that field, especially in connexion with the
establishment of the new medical school in Aleppo, from which the first
students would be.graduating during the five-year period.
His country's malaria eradication programme was proceeding satisfactorily:
no new cases of the disease had been detected during the present year and
there were no indications of insecticide resistance in Anopheles.
During .the past few years one-and-a-quarter million children aged
between six and fifteen years had been vaccinated against tuberculosis; it
was planned to convert the programme into a routine activity with provision
for laboratory diagnosis and other services.
It would be useful if a WHO expert could be assigned to assist the
Government in its plans for trachoma control.
With regard to the present cholera threat, he stressed the importance
of long-term planning, with application of strict preventive measures over
the next two years, and of inter-country co-ordination. WHO could play a
very useful role by organizing studies and conducting seminars on the subject.
Dr. TABBA'A (Saudi Arabia) said that a number of cases of cholera had
unfortunately occurred in his country. As soon as they had been bacteriolo
gically confirmed liffO had been informed and the necessary measures taken.
He ,.as glad to say that it had been possible to isolate the infected areas
from the rest 0f the country and thereby achieved complete control of the
disease. His Government WaS grateful for the WHO expert assistance received
and also for the supplies of vaccine which had made it possible to conduct
a country-wide inununization programme. In the present regrettable crisis,
he wished to stress the duty of any country where cases ocourred to inform
EM/RC20A!Min.2 page 8
WHO immediately: not to do so was like failing to inform one's neighbours
when one's house was on fire and thereby endangering th~ir houses too. In
view of the recent history of the spread of the disease, there were perhaps
grounds for seriously re-examining the role of carriers, which he felt was
not sufficiently taken into account by some authorities.
Finally, he stressed that his country was fully aware of its responsi
bilities in regard to disease prevention during the Pilgrimage season and
did everything in its power to fulfil them.
Dr. AL-NOURI (Iraq), referring to the two seminars on aspects of human
reproduction and family planning which were to be held in Teheran and
Baghdad, said he hoped that they would be followed up by further activities
in that fiel-d, .in vi.ew of its importance for the future of the Region.
He was glad to see that the Regional Director shared the views of his
country's Ministry of Health regarding the importance of education and
training of health personnel. In that connexion, he would like to draw
attention to the desirability of establishing unified training standards
throughout the Region.
Finally, he called for greater attention to the growing problem of
environmental pollution in the Region.
Dr. FAKHRO (Bahrain) said he was happy to be able to report that no
cases of epidemic diseases had occurred in his country during the past year,
and that for the first time in the history of Bahrain's Minist~J of Health
there had been no cases of poliomyelitis; the country had also remained
free of cholera. Thanks to vaccine supplies received from the United Arab
Republic, it had been possible to vaccinate the entire population against
cholera, but it was realized that the disease remained a serious threat. A
new strategy would have to be developed by the international community in
order to combat it, and for that further studies on the EI Tor vibrio would
be required, so he felt that WHO should increase its allocations for work in
that field. It was regrettable that certain countries had not reported cases
EM/RC20A/Min.2 page 9
occurring in their territories, and the matter should be discussed in full
under item 10 of the Agenda.
He welcomed the continued emphasis placed on problems of education and
training, since the development of effective health services throughout the
Region depended on their solution. In his own country, for example, owing to
the difficulty of finding Arabic-speaking nurse-educators it had not been
possible to implement fully the programme for training of nurses, though
the necessary funds were available and allocated. He considered that
frequent consultations should be held at the regional level to examine the
Organization's education .and training programme and adapt it to evolving
needs.
Under item 8 of its. agenda the Sub-Committee would be considering the
World Health Assembly resolution on limitation of smoking. His Government
fully supported the resolution and considered that practical measures should
be taken to implement it, including an agreement among Member countries
regarding the printing of warning notices on cigarette packets and provision
for an appropriate health education programme throughout the Region.
More attention should be paid to problems of mental health in the Region
and larger numbers of fellowships allocated in that field in order to over
come the acute shortage of qualified staff.
His Government was grateful to the Government of Kuwait for its
assistance in preparing a practical plan for combating tuberculosis, which should
solve the problem of tuberculosis for ten years at least.
He regretted that it was once again necessary at the present session to
call attention to the plight of the refugee victims of aggression in the
Region, and to the continued deterioration in their health conditions,
owing to the failure to implement the basic United Nations resolution on
the subject.
In conclusion, he thanked the Regional Director for the assistance
which had enabled his country to develop long-term health plans and implement
them according to, or even ahead of, schedule.
EMjRC20A!Min.2 page 10
Dr. KADIKI (Libya) said that the health programmes in his country were
progressing satisfactorily with WHO assistance. His Government had greatly
appreciated the recent visit by the Regional Director and hoped that it
could be followed by others.
His Government had noted with gratification the increased concern
shown by the Regional Office with education and training. It was particularly
interested in the matter as it was at present making considerable efforts
to increase its training facilities: for example, the capacity of the Health
Training Institute in Benghazi had been increased from 130 students to 300
and plans had been made to expand other training institutes in the country.
Some cases of cholera had been detected in Libya and had immediately
been reported to WHO. With assistance from the Organization in the form of
experts and vaccine supplies, the necessary preventive measures had been
taken and the entire population vaccinated - 80 per cent of it within the
first week. The problem of cholera would be discussed in detail under
item 10 of the Agenda, so at the present juncture he would merely state
that his Government deplored the refusal of certain countries in the Region
to report the cases which had occurred in their territories.
Dr. EL SAIDI (Yemen) said that the present session of the Regional
Committee coincided with the eighth anniversary of the revolution by which
the people of Yemen had rid themselves of the yoke of unde~-development and
isolation under a tyrannical regime. Since then the Ministry of Health had
been trytng, despite limitations of resources, to overcome age-old epidemiC
disease problems, and much progress had already been achieved thanks to the
country's own efforts and to the assistance of friendly countries, notably
Kuwait, and international organizations, particularly WHO and UNICEF.
His country was grateful to the Regional Office for sending experts
and advisers in various fields such as health education, radiology, eye
diseases, maternal and child health, laboratory services, community develop
ment and medical stores management. Those visits had been crowned in April
of the present year by a visit from the Regional Director himself to discuss
EM/RC20A/Min.2 page 11
the implementation of various health proje9ts in the country. Visits had
also been received from experts on malaria, smallpox and tuberculosis to
prepare programmes for the control of those diseases, and visits by other
experts were at present awaited. Large quantities of vaccine had also been
provided by WHO for preventive campaigns. In that connexion, he wished to
express his Government's. gratitude to the Government of the United Arab
Republic for supplying cholera vaccine.
In August 1970 his country had had a visit from the Regional Adviser
on Community Development and other members of a Preparatory Assistance Mission
to examine the possibility of establishing a manpower institute in Sana'a
and prepare a project for submission to the Special Fund of the United
Nations Development Programme. It was hoped that the project would soon
become a reality and his Government was ready to play its part to the full
in implementing it.
Thanks to WHO assistance, a number of health projects were progressing
satisfactorily in his country. A smallpox eradication campaign had been
started in 1969 and it was hoped to complete it by 1971: one million persons
had already been vaccinated. Progress was being made in the training of
health staff, thanks to the WHO fellowship programme, emphasis being laid
on preventive medicine since the country's resources were inadequate to
provide for curative services. Progress was also being made in expanding
the maternal and child health services and in providing basic health services
for rural areas based on mobile units operating from centres in the main
towns. Sewerage and drinking water supply projects were being prepared for
some of the major towns with WHO and UNDP/SF assistance. The Organization
had provided the services of an expert to help organize the department of
biostatistics in the Ministry of Health, and in that connexion he wished
to draw attention to the urgent need for some provision to be made to enable
national staff to obtain experience in the statistical departments of other
countries. Finally, an agreement had been signed for the establishment of
a central public health laboratory in Sana'a and he hoped that it would soon
be implemented.
EM/RC20A/Min.2 page 12
In addition to the above-mentioned programmes, his Government would
also like to have assistance from WHO in implementing programmes for the
eradication of malaria and tuberculosis and the control of communicable eye
diseases, which were a serious brake on productivity and educational progress.
Fellowships were also needed for training in various medical and paramedical
fields, including laboratory work and epidemiology. Finally, his Government
would be grateful for the services of an expert to assist in studying the
epidemiological conditions that existed in the northern part of the country
following the recent war.
In conclusion, he reiterated his Government's gratitude t~WHO and to
UNICEF for all the assistance it had received.
Dr. EL KADI (United Arab Republic) said that in the time available he
could not undertake to discuss the report as a whole, and in any case a large
number of points had already been commented on by previous speakers. He
would, however, like to stress that education and training remained one of
the paramount needs in the Region, since the available medical and para
medical staff was still quite inadequate for tackling its health problems.
However, .the number of medical training institutes in the Region was
increasing: in the United Arab Republic there were now seven medical schools,
producing 1 400 graduates per year, and an eighth would be opening the
following month. There had also been a great expansion in nursing and mid
wifery schools, which now numbered over sixty, together with two higher
nursing institutes which were receiving assistance from WHO in the form of
expert teaching staff. There were also four institutes for the training of
laboratory and radiological staff.
The budgetary proviSion for the allocation of fellowships in the Region
was certainly substantial, but his delegation would like to see it still
further increased in view of the vital importance of education and training.
His delegation strongly supported the suggestion, mentioned in the
report, for the establishment of a regional medical library, which would be
of great value particularly in research.
EMjRC20A/Min.2 page 13
He agreed with the emphasis laid in the report on t~ importance of
basic health services for controlling and eradicating communicable diseases.
His country now had some two thousand basic health units covering the rural
areas and linked with hospitals so that patients could receive specialized
treatment where required. These basic units were also closely co-operating
in family planning programmes, through the maternal and child health centres
included in each of them and equipped with UNICEF assistance.
With regard to pharmaceutical preparations, also mentioned in the
report, the travelling seminar which had visited Iran, Pakistan and his own
country, had been an important contribution to progress in that field.
Despite increased budgetary allocation fqr work on control of pharmaceutical
preparations in the United Arab RepubliC, however, his Government felt that
the problem was too large to be effectively tackled by anyone country
individually; a note prepared by his delegation on the subject of Regional
Centres would be distributed to participants in the Regional Committee
and he hoped it could be discussed at a later stage.
Dr. BAHRI (Tunisia) said that, with W~O assistance, his country was
trying to solve its health problems through the establishment of a sound
network of basic health services. The objectives of the malaria eradication
programme had been attained, and a joint evaluation by a WHO expert and
the national campaign director indicated that final success could be expected
in the near future. In the field of education and training, the first batch
of doctors trained entirely in Tunisia had graduated during the present year,
while in nursing education emphasis was being laid on the training of
specialized and supervisory staff whilst continuing the efforts in the field
of basic nurse training.
Family planning activities in Tunisia were being integrated into the
basic activities of the maternal and child health centres and a directorate
of family planning had recently been set up for that purpose. A programme
of research on family planning was to be launched with WHO assistance in
1971.
EMjRC20A/Min.2 page 14
Environmental health was continuing to receive attention and a specialized
school for the training of environmental health technicians was operating
in Nabeul with WHO assistance.
A multidisciplinary team was due to arrive in Tunis the following week
to discuss the plan for establiShing, with WHO assistance, a national
institute of public health.
TuniSia had been greatly concerned at the occurrence of a number of
cases of cholera in Libya, and he wished to pay tribute to the Libyan Govern
ment for its prompt action in informing his own Government as soon as the
very first case occurred, thus enabling it to take the necessary measures
to prevent the introduction of the disease.
Mr. AL-HIJJI (Kuwait) said that the Annual Report covered a vast range
of health problems which WHO made great efforts to detect and deal with.
Particular attention was given to the training of technical personnel, for
the excellent reason that if sufficient technical personnel were available
health standards in a country would be raised. The grant of fellowships had
had in the past, and would have in the future fruitful results in producing
qualified personnel of the standard required. Efforts should be pooled
throughout the Region to eradicate the endemic and epidemic diseases common
in it; for that reason more bacteriological laboratories were required and
more laboratory experts needed to be trained. Assistance to that effect
by WHO would be very useful.
The fact that pharmaceutical products were being manufactured in some
countries showed a rise in the technological capacities of the Region, and
he urged countries to develop production to the fullest extent pOSSible,
with the help of WHO. The pharmaceutical research that such development
would entail was of economic as well as scientific importance.
Among the other problems covered in the report was the shortage of health
statisticians in the Region. Statisticians were essential to health services,
and his country had had the benefit of consultants sent by WHO as well as of
a seminar for statisticians that he hoped would yield good results. Another
EM/RC20A/Min.2 page 15
problem in Kuwait that caused special concern was air poliution. The value
of environmental health needed no emphasis, and the rise in social stand~rds
in countries had led to the increasing use of pesticides. Unfortunately,
houseflies and some mosquitos had developed resistance to the insecticides
employed against them and it was desirable that new methods for their
contro:). should be developed. In order to deal with the physically handi
capped, small industries should be developed as well as equipment such as
artificial limbs to help them compensate for their handicaps; perhaps the
Red Cross and the Red Crescent could provide some assistance. The last
point he wished to raise was in relation to radiation detection. The use
of ionizing radiation needed to be subjected to strict regulation, and seminars
were needed throughout the Region to instruct countries on what to do.
Dr. JALLOUL (Lebanon) expressed the pleasure of his Government in being
host to the meeting of the Sub-Committee. He was in entire agreement with
what other speakers had said on the value of WHO assistance in the Eastern
Mediterranean Region. Similar health conditions in countries needed similar
solutions, and one of the problems of greatest urgency in countries of the
Region was the establishment of a good central and peripheral general
organization for health. If such an organization was established, it would
be easier to provide adequate health services and so raise health standards.
For that purpose money and qualified personnel were needed. ~ development
of health organization on such lines was needed in the Region, as the Report
showed. It was also to be hoped that the Region would be able to catch up
with technical progress. His own country was making every effort to do so,
and was grateful to WHO for its assistance.
The REGIONAL DIRECTOR, replying to the comments of the various speakers
on the Annual Report, dealt seriatim with the most important points they had
raised. The Representative of Cyprus had referred to the need for a seminar
on cholera. PrOVided the Sub-Committee agreed, he was entirely in favour of
one that would include all the countries of the Region and perhaps a number
of countries outside the Region. He fully agreed with the Representative of
Afghanistan that it was important to co-ordinate campaigns against malaria
EM/RC20A/Min.2 page 16
and other communicable diseases. As the Representative of Sudan had pointed
out co-ordination was also extremely important in all health programmes. He
had no doubt that the United Arab Republic would agree to co-ordinating its
health activities in relation to Lake Nasser, and he felt that meetings
between countries in order to co-ordinate their communicable disease control
campaigns would be of value. As the Representative of Somalia had said, the
training of nurses and other auxiliary workers was of the utmost importance
in the Region. The same Representative had stressed the need to consider
the policy of granting fellowships, which needed to be reorientated so that
more stress was placed on post-graduate study. The Representative of Iran
had referred to the importance of environmental health; his invitation to
hold a seminar in Iran on rural health would be kept in mind when revising
the 1971/72 programme. The Representative of Pakistan and a number of other
countries had also stressed the role of public health laboratories and the
importance of medical libraries. Medical education too had been emphasized
by a number of Representatives. In relatiQn to the medical school at Aleppo
referred to by the Representative of Syria, he was glad to see that it was
making progress and he thought that it might easily become one of the most
important medical schools in the Region. The health problems in relation to
the pilgrimage to Mecca mentioned by the Representative of Saudi Arabia were
of concern to all countries in the Region. The measures taken by the Saudi
Arabian Government were comprehensive and liRO would assuredly give every
assistance towards making them as perfect as possible.
Several Representatives had mentioned family planning. He agreed with
the Representative of Iraq that it was important to follow up the seminars
on the subject that had been held in Teheran and Baghdad. He also agreed
with that Representative that some effort should be made to unify standards
of medical education in the Region. The question of the equivalence of
medical degrees had been discussed by both the World Health Assembly and
the Executive Board. He hoped that it would be discussed also at the
Teheran Conference on Medical Education. No doubt it would be one of the
main concerns of the Association of Medical Schools in the Middle East.
EM/RC20AjMin.2 page 17
The Representative of Bahrain had stressed the need ,to pay more
attention to mental health in the Region. It was true that mental health
problems were increaSing in importance with the progress of urbanization
and industrialization in the Region, and it was clear that WHO would have
to do more in the future in that field.
The stress placed by other Representatives on such subjects as health
manpower, health statistics, air pollution, the need for a good network of
basic health services, and the reorientation of the fellowship programme
would all be taken into account when the programme was being prepared for
future years. All the special comments and suggestions had been noted,
and he would bear them in mind in relation to the needs of countries and
the finances at his disposal.
As there ware no more comments, the CHAIRMAN read the following draft
resolution:
"The Sub-Committee,
Having reviewed the Annual Report of the Regional Director
covering the period 1 July 1969 to 30 June 1970;
Considering the growing need for health services to cope with
the health problems associated with the rapid social and economic
development which is taking place in the Region;
Noting the necessity for control and eradication of endemic
and epidemic diseases which still represent major health problems
in the Region;
Emphasizing the need for progressive integration of mass
campaigns for control of diseases into basiC health services;
Being aware that an increasing number of countries were
adopting policies relating to population which require wider
provision of family planning services as an extension of maternal
and child health services;
Appreciating the enVironmental problems associated with
urbanization, industrial and agricultural development,
EM/RC20A/Min.2 page 18
1. ENDORSES the high priority given to the training of national
health manpower, .the emphasis on control and eradication of
communicable diseases, improvement of environmental health,
community water supplies, development of laboratory services,
nutrition and radiation protection;
2. COMMENDS the Regional Director for his factual and comprehen
sive report and for his clear-sighted approach to the health and
socio-economic problems of the Region."
In view of the fact that the forthcoming year was the last in the
Regional Director's term of office, and because of the excellent work the
Regional Director had carried out in the Region, he proposed ··that a third
paragraph should be added at the end of the resolution reading:
"3. EXPRESSES the hope that the Regional Director will find it
possible to offer his candidature for a further term at next
year's elections in order to complete the excellent programme of
work being carried out in the Region.
Brigadier HASAN (Pakistan) and Dr. EL SAIDI (Yemen) supported the
Chairman's proposal for an additional paragraph.
The additional paragraph Nas adopted.
Dr. ABDEL HADI (Libya) proposed the addition of the words "and cautious"
after the word "progressive" in the fourth paragraph of the preamble.
After a discussion, it was agreed to replace the Nord "progressive"
by the words "carefully planned" in the fourth paragraph of the preamble.
On the proposal of Dr. EL RAnI (United Arab Republic), it Nas agreed
to add the words "medical research'·' before the words "and radiation
protection" at the end of the first operative paragraph.
Decision: The draft resolution, as amended, was adopted.
EMjRC20A/Min.2 page 19
2. CO-OPERATION WITH OTHER ORGANIZATIONS AND AGENCIES •. STATEMENTS .AND REPORTS BY REPRESENTATIVES AND OBSERVERS OF ORGANIZATIONS AND AGENCIES: Item 6 of the Agenda
Dr. HAFEZI, Observer for the World Federation of Public Health
Associations, conveyed the greetings of his Federation to the Sub-Committee.
The Federation was now four years old and in the process of growing rapidly.
It comprised twenty-five national associations from all the WHO regions,
including Iran and Pakistan from the Eastern Mediterranean Region, while
Sudan had applied for membership. The Federation would welcome applications
for membership from the national associations in Lebanon and the United Arab
Republic, and it hoped that other countries would set up their own
associations, which would eventually join it.
Like WHO, the aims of the Federation were to raise health standards
throughout the world. It was very willing to co-operate in matters of
mutual interest and it hoped that there would be close future collaboration
with all national associations and with WHO. Fruitful collaboration had been
established with the Regional Office and he wished to express his gratitude
to the Regional Director for what had already been achieved.
Dr. NAZER, Representative of the International Planned Parenthood
Federation, said that the task facing his Federation and the world in
general in the coming decade was extremely challenging. It was necessary
to increase the education and training of medical and auxiliary workers in
the principles of planned parenthood, and he hoped that WHO would give the
problem special consideration. Much was already being done in countries
wi th family planning programmes, among which were to be counted Iran, TuniSia
and the United Arab Republic.
The Federation had opened a regional office in Beirut on 20 April 1970,
and was grateful to the Lebanese government for the help it had provided.
The work of the office extended over the countries of the Region and
included Algeria and Morocco. The Federation was arranging to hold a seminar
in February 1971 on "Induced abortion, a hazard to public health". It hoped
to receive co-operation and help from the ministries of health in the
EM;RC20AjMin.2 page 20
Region. It already received considerable co-operation from countries in
the Region and it hoped that this would continue both with them and with
the international agencies, especially WHO. The great aim of the Federation
was to promote both the health and the quality of human beings, and in that
its aim coincided with that of WHO.
Mr. EL KHOURI, Observer for the International Statistical Education and
Research Centre, said that the Annual Reports of the Regional Director were
a mine of valuable information. In many of them the importance of training
in statistics had been stressed, but in spite of the emphasis statistics
were still poor throughout the Region. Improvement had been made, but the
countries in the Region still had a long way to go. Well-organized
institutions were needed, but unfortunately there was a shortage of teaching
staff at all levels. With the assistance of the Centre five countries had
set up statistical services. The need, however, was urgent for specialized
training, and the Centre had been trying to concentrate on that since 1967;
but so far it had received little assistance from agencies or institutions.
The Centre provided many facilities for training statisticians, and he hoped
that the countries of the Region would take advantage of them.
Dr. SAWAYA, Representative of the International Dental Federation, said
that dental care - especially preventive dental care - was in short supply
in countries of the Region. The average number of dentral graduates every
year was insufficient for the population; there were not enough schools of
dental education; and dentists were concentrated in the urban areas. He
would be happy if WHO gave its assistance in encouraging countries to train
more dentists, give pUblicity to the need for prophylactic dental measures,
press the school authorities to employ dentists in the schools, and award
special terms to dentists to work in the rural areas. There was room for
the. exchange of views and experience between dentists in the various
countries of the Region.
Mr. KOLEILAT, Deputy Regional Director for the Eastern Mediterranean
Region, United Nations Children's Fund (UNICEF), conveyed the greetings of
UNICEF to the Sub-Committee. UNICEF continued mobilizing its resources to
EM/RC20A/Min.2 page 21
meet the challenge of the United Nations Second Development Decade with a
view to bringing to the children and youth of the world the care and support
to which they were entitled, both as the ultimate object of development and
as the basic instruments through which development could be achieved. The
UNICEF Executive Board had changed its approach in 1961 and adopted what
was termed the "country approach"; and it had reaffirmed its new approach in
1967 and again in 1970. In 1970 it had stressed the need for intersectoral
action to meet the varying yet closely inter-related needs of children.
The Executive Board in. 1970 had approved allocations to health projects
amounting to $ 19.4 million, over four-fifths of which was to build up basic
health services with the stress on a maternal and child health service
network. In co-operation with WHO, UNICEF was assisting basic health
programmes in some ninety countries and had helped equip more than 45 600
rural health centres and sub-centres. Nevertheless, the coverage of basic
health services was still inadequate in most countries.
The 1970 Session of the Executive Board had also paid ponsiderable
attention to the increasing adoption of policies relating to population
involving the extension of maternal and child health services. Aid for
family planning was approved for a number of countries.
The Board had also approved recommendations of the UNICEFjWHO Joint
Committee on Health Policy that anti-malaria campaigns should be reappraised
both in respect of the technical aspects and in respect of administrative,
operational and financial factors. UNICEF would continue to help campaigns
that had a good prospect of success for a further limited period. It would
phase out its assistance to other campaigns, but might provide limited
assistance in areas of highenliend!city and where malaria eradication was
not feasible at present.
Dr. SHARIF, Director of Health Services of the United Nations Relief
and Works Agency for Palestine RefUgees in the Near East (UNRWA), greeted the
members of the Sub-Committee and conveyed the greetings also of
Dr. Lawrence Michelmore. He also thanked the Sub-Committee for the invitation
extended through United Nations Headquarters.
EM/RC20A/Min.2 page 22
The United Nations Relief and Works Agency for Palestine Refugees in
the Near East (UNRWA) had completed twenty years of activities in support of
some 1400 000 refugees, and continued to provide for their growing needs
according to its financial means and notwithstanding the vicissitudes in the
refugee community and the Agency itself. The services had kept pace with
those in Arab host states. They had been maintained at a satisfactory level,
and some modest improvements had been possible thanks to special donations
and to .the lack of any great movements of the refugee population since
July 1968. He mentioned in particular improvements in accommodation for the
health services, the construction of new health centres and nutrition centres,
and the extension of regular health supervision in infant health clinics
to include children in the third year of life, except in Gaza, where it was
hoped to extend that preventive measure also as soon as staff became
available and conditions in the area improved. The immunization programmes,
particularly against diphtheria, pertussis, tetanus and poliomyelitis, had
been strengthened, and BCG vaccination was being extended among infants
and schoolchildren. He also mentioned the institution of a study on
incidence of goitre among schoolgirls in Damascus, the strengthening of
dental services at three health centres, the establishment of two new
clinical laboratories in East Jordan, improvements in feeding facilities,
and the improvement of environmental sanitation by partial replacement of
pit-privies by septic-tank latrines in the emergency camps in Syria and
East Jordan, as well as the replacement by pre-fabricated shelters of the
tents in the latter camps.
Substantial improvements have been made at the Bureij Tuberculosis
Hospital in Gaza, a new health centre was in use at Marka Camp and another
under construction at Zerka, and plans were underway for an infant health
centre at Amman New Camp, all thanks to special donations. Residential
accommodation was almost completed for health staff living in the East
Jordan Emergency camps and on call after normal clinic working hours, and
dining-halls were being built there to serve a daily hot meal. In Syria,
work had begun on construction of a new supplementary feeding centre at
Dera • a Camp.
EM/RC20J)/Min.2 page 23
Giving details of the comprehensive curative and preventive medical
services provided by UNRWA, he said that there were a total of 112 points
at which it operated: eighty-nine directly by UNRWA, fifteen by Agency
subsidized voluntary societies and eight by governments. He gave details
of the "family file" system which had been extended to all centres, enabling
the treating medical officer to evaluate family health status, and of a
register of eighty congenital and chronic conditions created in each centre.
There were also four additional diabetic clinics.
Hospitalization of patients from refugee camps was arranged by the
Agency in its hospitals and those subsidized by it, and in government and
private institutions. He gave details of the hospitals and wards maintained
by UNRWA to serve different camps, the number of hospital beds, and laboratory
services, including those developed during the period under review.
Reporting on communicable diseases, he said that none of the quaran
tinable diseases had made their appearance among the refugees, nor had
epidemic typhus or relapsing fever, though there had been important outbreaks
of whooping cough and influenza. The incidence of the latter had fallen off
early in 1970, and excess mortality had been low, Cholera had occurred in
sporadic cases in camps in all areas except Gaza, but in spite of the
difficult conditions in the Region, it had been possible to control the
disease.
UNRWA cont.inued to provide maternal and child care through some eighty
maternity and seventy-nine infant clinics, using midwifery and nursing teams
and providing paediatric services, as well as issuing extra rations and
skimmed milk to pregnant and nursing women. Surveys conducted during the
period indicated that nutritonal anaemia in pregnancy was an important problem
in Lebanon, Syria and East Jordan camps at least. Preventive . measures included
education of mothers and provision of supplementary diet and iron treatment.
Surveillance of the nutritional status of refUgees' children Was maintained
on a comparative basis, determining signs nf underweight and malnutrition
in the different camps. Rehydration/nutrition centres served a valuable
P\lI'POse in serious cases' of malnutrition as well as of gastro-enteritis.
EM;RC20A/l1in.2 page 24
Studies were developed more systematically in 1969 on infant mortality to
help assess health problems. Rates appeared to be falling substantially,
except on the West Bank camps. Nutritional deficiency was associated with
about one-third of the deaths ascribed to diarrhoeal diseases.
He went on to give details of school health services, the health
education programme, which continued to emphasize the education of mothers
in special clinics and children in schools on the basic elements of health;
nursing services, which had considerable responsibility in maternal and
child health clinics, home visiting, feeding, immunization, disease control
and health education; and he outlined the role of the nutrition and
supplementary feeding services as an essential component in preventive health
measures, including regular surveillance of specially vulnerable groups.
After describing the environmental sanitation improvements carried out
in 1969, in connexion with which he mentioned the replacement of tents by
pre-fabricated shelters and improvements in wastes disposal and water supply,
he emphasized the need for health staff and UNRWA's own medical education
and training programme among refugee stUdents. He drew attention to the
fact that the theme selected for the 1969/70 programme was "UNRWA's health
services; what they offer and how they can best be utilized in promoting
individual and community health".
Finally, he stressed the individual and collective responsibilities
in the field of health as it related to the conditions of refugees and
displaced persons. Despite the Agency's deteriorating financial situation,
major reductions in the health services had been avoided so far, but any
further reductions would certainly cause great hard&~P to the refugees,
some of whom depended exclusively on these services.
The CHAIRMAN drew attention to the following draft resolution on co
operation with other Organizations and Agencies:
"The Sub-Committee,
Having heard with interest the statements and reports of
Representatives of Organizations and Agencies,
EM/RC20AjMin.2 page 25
1. THANKS UNDP, UNICEF and UNRWA and the other Organizations
for their collaboration with WHO in health programmes of the
Region;
2. EXPRESSES its satisfaction with the continuing close co
operation between international organizations in fields related
to health."
Decision: The resolution was adopted.
3. LONG-TERM PIANNING IN THE EASTERN MEDITI!:RRANEAN REGION: Item 7 of the Agenda
(a) FIFTH GENERAL PROGRAMME OF WORK FOR A SPECIFIC PERIOD: Item 7(a) of the Agenda (Document EM/RC20/7)
(b) LONG-TERM FINANCIAL INDICATORS: Item 7(b) of the Agenda (Document EM/RC20/8)
Dr. HASAN (Secretariat), introducing the item at the inv:!ttation of the
CHAIRMAN, said that the second part of the item, concerning long-term
financial indicators, was a new aspect. The programmes which WHO assisted
were essentially nationa~ programmes elaborated and paid for largely by
governments. Since 1952, when the World Health Assembly ~ad first decided
to lay down programmes of work covering a specific period, four such pro
grammes had been developed, in which countries had been expected to develop
their activities in accordance with the essential programme through the
intermediary of the Regional Offices. The Twenty-second WOrld Health
Assembly had laid down certain guidelines for the preparation of the fifth
programme of work; at the Twenty-third, while extending the fourth programme
of work to cover a further year, had decided to reverse the process by
asking governments to elaborate plans first at the national level, which
would be co-ordinated in the Regions before assimilation in an international
programme by Headquarters.
At the same time, national governments had been asked to elaborate
their plans according to certain criteria and to give information where
possible on the financial aspects of the plans. Unfortunately, while
indicating that the criteria were acceptable, countries had in most cases
EM/RC20A/Min.2 page 26
not been able to give information on financial targets. The documents before
the Sub-Committee were therefore only generally indicative of priorities
for the countries in the Region.
The Jackson Report on the Capacity Study on the United Nations and the
Specialized Agencies had concluded that if the budgets of organizations
were to double over a number of years they would have to have more information
of a financial nature from the countries in which projects were being
carried out if they were to be sure of implementing the programmes. The
documents also analyzed that aspect of long-term planning, recognizing that
programmes should be based on sound financial indicators.
He said that certain basic priorities in the health field had been
recognized by the Governing Council of UNDP, which also had implications
for WHO.
The programmes of the last twenty years had been analyzed in preparing
the documents before the meeting, and Representative's comments would be
noted as a valuable source of additional material for planning procedures.
He pointed out that priorities were indicated in the section of the report
starting on page 9 of Document EM/RC20/7. He also drew attention to the
attached resolution of the Twenty-third World Health Assembly, resolution
WHA23·59.
The complex problem of indicative planning figures was dealt with in
a separate document, EM/RC20/8.
Dr. VASSlLOPOULOS (Cyprus) stressed the importance 'of education and
training in a Region where the shortage of health staff was acute. Although
in Cyprus, which had a doctor/population ratio of 1/1 270, the situation
was not as desperate as in many other countries. There was no institution
for post-graduate medical studies. He praised WHO'for the assistance it
gave in education and training, and emphasized the need for medical and
paramedical staff to be trained in the countries where they were to serve
and in the disciplines which would be useful to them there.
EMjRC20A/Min.2 page 27
The strengthening of basic health services was also a .aubject of high
priority in which WHO's advice was invaluable. Improvements were needed in
the field in all countries in varying degrees.
After mentioning the priority to be accorded to family planning and
maternal and child health, care of the elderly and handicapped, he said that
no efforts should be spared to eradicate major communicable diseases in
the countries where they were endemic in order to prevent their spreading
to other countries in the Region. In Cyprus only echinococcosis gave
serious cause for concern at the present time.
The importance of the environment and its effect on health could not
be too heavily emphasized. The trend towards urbanization and industrializa
tion in recent years had aggravated the situation in regard to water supplies
and other health essentials. Cyprus had already passed the goal set for
1980 under the Second United Nations Development Decade regarding water
supplies, but he felt that high priority should be accorded to such environ
mental factors to encourage assistance from the United Nations, specialized
agencies and UNDP to help improve environmental factors.
Mr. HASSAN (Somalia) said that his country also accorded high priority
to education and training, but had no higher training institutions on its
territory. Negotiations were underway with a friendly country with a view
to ensuring the training of doctors partly in, and partly outside the
national frontiers, aimed at the development of a health team capable of
dealing with the specific health problems of Somalia,
Nutrition, he thought, had been given too low a priority, since without
adequate standards of nutrition it was impossible effectively to combat any
health problem.
Dr. ~ (United Arab Republic) said that education and training
and the strengthening of basic health services were linked, in his opinion,
as the two subjects deserving the highest priority. The United Arab Republic
was intent on developing well-organized health services in a wide network,
mobilizing all available resources.
EM/RC20A/Min.2 page 28
Research had perhaps not been given sufficient attention, and an enquiry
should be made into the kind of assistance needed to develop it, for example
through the building up of library services and the strengthening of labora
tory services.
Brigadier HASAN (Pakistan) said that his country agreed on the
difficulties expressed in Document EM/RC20/8 on financial indicators, but
stressed that although most governments would be able to indicate the
priorities and financial targets involved in their health plans by the next
WHO Executive Board session,developing countries were particularly vulner
able to factors which upset such planning and which were sometimes as violent
when they were due to internal as when they were due to external conflicts.
Those countries also depended on loans - increasingly so when foreign aid
was dwindling, and delays of several months were often caused by the failure
of loan agencies to make up their minds.
Pakistan was in full accord with the programme of work as summarized
on page 21 of Document EM/RC20/7. In its own Fourth Five-Year Plan, launched
recently, the major programmes and targets were for the malaria and smallpox
eradication programmes, BCG immunization and tuberculosis control, leprosy
control and maternal and child health.
He enumerated the aims of Pakistan's rural health programme assisted
by UNICEF for which the training of teachers for the school of paramedical
personnel would be assisted by WHO. The training of health workers would
include the subject of nutrition. It was intended to provide 25 300 more
hospital beds to bring the ratio to 1/23 000, and to expand institutions
for medical and paramedical education and training accordingly, for which
WHO's assistance would be needed.
The malaria and smallpox eradication and BCG immunization programmes
would all enter the maintenance phase and be integrated in the rural health
services during the fourth Five-Year Plan. Efforts would be made to attain
self-sufficiency in pharmaceutical and biological production, which would
require expansion and improvement of existing laboratories for sera and
vaccines.
EMjRC20A/Min page 29
"Centres of Excellence" for post-graduate medical education and research
were planned to train public health engineers and health economists needed
in addition to doctors and administrators. WHO assistance would again be
needed to help expand institutions for that purpose. The assistance of WHO
and UNICEF would also be needed for the continuation of water supply and
waste disposal programmes.
Having thus made it clear what Pakistan's health priorities were, he
added that greater priority was given to nutrition than to non-communicable
chronic diseases.
Dr. ROASHAN (Afghanistan) said that the order of priorities as far as
his country was concerned was as follows: education and training, strengthening
of basic health services, research, communicable disease control, environ
mental health, nutrition and non-communicable chronic diseases. It was
realized that health priorities varied with different areas, and it was
difficult to raise the level of health services uniformly, but that should
be the goal. In Afghanistan, haalth planning was being developed as part
of the Fourth Five-Year National Development Plan. Basic applied and
operational research should be given due consideration as an essential
to health planning.
An important factor in education and training was the quality of training
to be given to different categories of health staff. He believed that staff
should be trained according to local needs.
Afghanistan was already placing emphaSis in its plans on the develop
ment of basic health services through the strengthening of rural and provin
cial health centres. Nutrition should also receive proper attention among
health priorities, as in Afghanistan the question,was not mainly one of food
shortages but of specific nutritional deficiences, food hYgieneand wastage.
Dr. JALLOUL (Lebanon)' said that he was convinced of the soundness of
the documents before the meeting. Since all countries were determined to
raise health standards by positive action, workable solutions ,must be sought
and priorities allocated after careful analysis of the problems, which
EM/RC20A/Min.2 page 30
included health statistics, environmental health, health education, labora
tory services, chronic diseases, accident prevention and occupational health
among others. It was up to each country to deal with its problems according
to its priorities.
Dr. FAKHRO (Bahrain) said that the reports had outlined the most
important priorities in the health field, but he understood that those
who had prepared the documents would have been glad to have more specific
financial data. Coming from a small country, he would limit his remarks
to certain details.
He agreed that education and training should receive priority in the
coming five years, but he had noted the desire repeatedly expressed by
many delegates to the World Health Assembly in past years for a degree of
uniformity in standards of medical and paramedical training in different
countries, eo that one country could rely on the certificates issued and
qualifications given by the training institution in another. High priority
should be given to the training of teachers, and the fallacy that those who
did good research could be made good teachers must be abandoned. He agreed
with the Representative of Pakistan on the need to determine priorities
within priorities, especially in education and training.
In connexion with the strengthening of basic health services, he commented
on the absence of regional studies on the cheapest and most functional
methods f~~ the construction of health centres, which must also be adaptable
to advanc€· in medical knowledge. He advocated studies also of instances
in which health centres had in some countries been integrated with other
facilities in general cultural centres.
In addition to the need for communicable disease control, where his
country gave priority to tuberculosis and trachoma, he emphasized the need
for chronic disease treatment and rehabilitation, as such conditions had
developed rapidly in the Region with the increase in life expectancy and
in accidents.
EMjRC20A/Min .2 page 31
Dr. HASAN (Secretariat) said that the Representatives' many helpful
comments had been noted and would be used in the final preparation of
the programme.
The REGIONAL DIRECTOR said that the order of items as they appeared
on page 21 of Document EMjRC20/7 did not indicate a definite order of
priority, as it was recognized that each country clearly had different
priorities depending on local conditions.
The CHAIRMAN invited comments on the following draft resolution:
"The Sub-Committee,
Having considered the document on the Fifth General Programme
of Work for a Specific Period for the Eastern Mediterranean Region,
presented by the Regional Director;
Recalling the resolutions of the Eighteenth and Nineteenth
Sessions of the Regional Committee and the Twenty-second and
Twenty-third World Health Assemblies;
Considering the health situation in countries of the Region
and the priorities established by the governments for various
health activities in their national plans,
REQUESTS the Regional Director to continue to give priority
to the following activities in providing assistance to countries
of the Region during the period 1973-1977, in keeping with the
constitutional functions of the Organization and directives of
the previous World Health Assemblies and the Regional Committees:
(i) Medical education and training of health service
personnel including libraries and post-graduate education
and research facilities;
(ii) Strengthening of national health services including
national health and manpower planning; improving the
utilization of the available health resources; developing
of a network of health centres and sub-centres including
integration of mass campaigns for control of various diseases
EMjRC20A;Min .2 page 32
into the health services; expansion &~d development of
maternal and child health services, and family planning
activities; and health education;
(iii) In establishing a system of epidemiological sur
veillance; intensification of control of communicable
diseases including malaria, smallpox, cholera, tuberculosis,
communicable eye diseases and other infectious and para
sitic diseases;
(iv) Assistance in the development of programmes for the
prevention, control, treatment and rehabilitation for non
communicable and chronic diseases such as cancer, cardio
vascular, mental and geriatrics;
(v) Improvement of conditions in environmental hygiene in
which people live and work, namely, housin& community water
supply, environmental pollution, waste disposal and radiation
hazc.rds;
(vi) Elimination of nutrition disorders and general im
provement of the nutrition state of vulnerable population
groups;
(vii) Introduction of new area of health activities and re
search and co-ordination of research which is being undertaken
in countries of the Region."
Dr. GAIAL (United Arab Republic), proposed the addition of the words
"applied and operational" before "research facilities" in sub-paragraph (i)
of the first operative paragraph, in order to introduce the more specific
terminology used earlier by the Representative of Afghanistan.
It was so agreed.
Dr. GAIAL (United Arab Republic), further proposed the addition of a
sub-paragraph (Viii) to read as follows: "Improvement of drug quality control
services and manufacturing practices on an international basis, as well as
assistance in establishing co-operation through regional services".
EMjRC20A/Min.2 page 33
After an exchange of views in which Dr. GAIAL (United Arab Republic),
the REGIONAL DIRECTOR and Brigadier HASAN (Pakistan) took part, it was agreed
to add the words: "and pharmaceutical quality control" at the end of sub
paragraph (ii).
Decision: The resolution was adopted as amended.
The CHAIRMAN called for comments on the following draft resolution on
long-term financial indicators:
"The Sub-Committee,
Having reviewed the document submitted by the Regional Director
on the above subject;
Bearing in mind resolution EB45.R13 of the Forty-Fifth Session
of the Executive Board on Long-term Financial Indicators;
Agreeing that this complex subject requires more detailed study
including' consultations with governments carried out through the
Regional Office,
1. BELIEVES that further consideration of this matter should be
postponed until the Regional Committee has had an opportunity to
consider at its next session the outcome of the consultations with
governments;
2. REQUESTS the Director-General to include in his report to the
Forty-seventh Session of the Executive Board the recommendatiOns
and the view expressed by this Committee."
Mr. HASSAN (Somalia) said that the fact that developing countries often
had to change their priori ties and modify financial allocations accordingly
should be mentioned in the draft resolution.
The REGIONAL DIRECTOR reminded Representatives that the resolution was
of a preliminary, comprehensive nature, and assured the Representative of
Somalia that his consideration would be taken into account when the more
specific details of the programme were determined.
It was so agreed.
Decision: The resolution was adopted.
EMjRC20A;Min.2 page 34
4. RESOLUTIONS OF REGIONAL INTEREST ADOPl'ED BY THE TWENTY-THIRD WORlD IJEALTH ASSEMBLY AND BY THE EXECUTIVE BOARD AT ITS FORTY-FIFTH AND FORTY-SIXTH SESSIONS: Item 8 of the Agenda (Document EMjRC20j6)
The REGIONAL DIRECTOR said that the following resolutions of regional
interest had been adopted by the Twenty-third World Health Assembly and the
Forty-fi~th and Porty-sixth Sessions of the Executive Board: resolution
EB45.R20 on the smallpox eradication programme; resolution WHA23.10 on the
award of the Dr. A.T. Shousha Foundation Medal and Prize; resolution WHA23.12
on Measures Taken in Pursuance of the Revised Local Strategy of Malaria
Eradication; resolution WHA23.13 on the Real Estate Fund; resolution
WHA23.15 on Appropriation to the Real Estate Fund; resolution WHA23.30 on
the implementation of resolution WHA7.33; resolution WHA23.32 on the health
consequences of smoking; resolution WHA23.34 on present problems of yellow
fever in Africa; resolution vrHA23.35 on training of national health personnel;
resolution WHA23.36 on community water supply; resolution WHA23.52 on health
assistance to refugees and displaced persons in the Middle East; resolution
WHA23.60 on the human environment; and resolution EB46.R13 on the subjects
for technical discussions at the Twenty-Fifth World Health Assembly.
In connexion with the training of national health personnel, a draft
resolution had been prepared to inform the World Health Assembly and the
Executive Board on the views of the Region. The draft resolution, which
endorsed what Representatives had said in the discussion on long-term planning
with regard to the priority to be given to training, read as follows:
"The Sub-Committee,
Having reviewed the Resolution WHA23.35 adopted by the Twenty
third World Health Assembly and brought to its attention by the
Regional Director;
Considering the responsibility of the national authorities
in building up the health manpower according to the needs of the
country ,
1. RECOMMENDS that Member States give high priority to education
and training programmes for various categories of health personnel;
EMjRC20A;Min.2 page 35
2. STRESSES the need for national health manpower studies, in
the context of the country's health planning, with particular
reference to the formulation of curricula for the training
programmes;
3. REQUESTS the Regional Director to emphasize training of
health personnel as an integral part of general health planning,
requiring adequate curricula and appropriate methodology."
After an exchange of views in which Dr. AL-NOURI (Iraq), Dr. KHAILAF
(United Arab Republic) and the REGIONAL DIRECTOR took part, it was agreed
to add the words: "including inter-country programmes" at the end of
operative paragraph 2.
Decision: The resolution was adopted as amended.
The REGIONAL DIRECTOR drew attention to the following draft resolution
on resolutions of regional interest:
liThe Sub-Commi ttee ,
Having reviewed the document submitted by the Regional
Director drawing attention to resolutions of reg+onal interest
adopted by the Twenty-third World Health Assembly and the Executive
Board at its Forty-fifth and Forty-sixth Sessions,
TAKES NOTE of the contents of these resolutions."
Decision: The resolution was adopted.
The meeting rose at 1.30 p.m.
